Cold and Flu Tablets: What’s in Them, Mixing Medicines, Pregnancy and Safety (UK)

What’s in cold and flu tablets?

Most UK cold and flu tablets, capsules and sachets combine a painkiller (usually paracetamol) for aches and temperature with a decongestant for a blocked nose. Some add caffeine, a cough ingredient or a drowsy antihistamine. The label lists every active ingredient, so read it before taking anything else.

Real examples, with amounts, are in the sachets vs capsules table below.

Can you take cold and flu tablets with paracetamol?

No, not if the cold and flu product already contains paracetamol, and most do. The NHS says don’t take paracetamol at the same time as other products that contain it, such as cold and flu remedies, because you may take too much, which can be dangerous. Too much paracetamol can seriously damage the liver.

The NHS limit for adults taking 500mg paracetamol tablets is 1 or 2 at a time, at least 4 hours apart, and no more than 8 in 24 hours. Count the paracetamol in every sachet, capsule or tablet towards that total. Adults under 50kg, and people with liver or kidney problems or who drink heavily, should check with a pharmacist first.

Can you take cold and flu tablets with ibuprofen?

Sometimes, but check both labels and ask a pharmacist first. The NHS says not to use other cough and cold medicines if you’re already taking paracetamol and ibuprofen tablets, because it’s easy to take more than the recommended dose. Some cold and flu products contain ibuprofen themselves.

• Adults can take plain paracetamol and plain ibuprofen together if needed, the NHS says, but try each on its own first.
• Don’t take ibuprofen with other anti-inflammatories such as naproxen or aspirin.
• Ibuprofen may not suit you if you have asthma, a stomach ulcer now or in the past, heart, liver or kidney problems, or are pregnant.

Can you take cold and flu tablets with antibiotics?

Often yes, but ask a pharmacist to check your exact antibiotic first. The NHS lists flucloxacillin among medicines that may not mix well with paracetamol, which is in most cold and flu tablets. The pharmacist who gives you the antibiotic can check every ingredient. Antibiotics also don’t treat a cold or flu, because both are viruses.

Also check the antibiotic’s leaflet: the NHS says avoid alcohol completely with metronidazole and tinidazole. More on telling the two illnesses apart in cold vs flu.

Can you take cold and flu tablets when pregnant?

Usually not the combination kind. The NHS says don’t use decongestants if you’re pregnant, and most cold and flu tablets contain one, such as phenylephrine or pseudoephedrine. Paracetamol on its own is usually the best painkiller in pregnancy, the NHS says. Avoid ibuprofen unless a doctor or pharmacist advises it. Ask a pharmacist or midwife before taking any cold remedy.

• Check every product, not just the brand: the UK bumps service (Medicines in Pregnancy) says some Lemsip, Beechams, Benylin and Covonia products and all Sudafed products contain a decongestant.
• Breastfeeding: paracetamol is usually the best painkiller. The NHS says pseudoephedrine is usually not recommended and may reduce your milk supply, so ask a pharmacist for an alternative.
• Flu in pregnancy: the NHS says get an urgent GP appointment or call 111. The flu jab is free in pregnancy (see flu jab side effects).

What is phenylephrine hydrochloride, and does it work?

Phenylephrine hydrochloride is the decongestant in many UK cold and flu tablets and sachets. In September 2023 a US FDA advisory committee unanimously concluded that the data don’t support oral phenylephrine as a nasal decongestant at the usual dose. In November 2024 the FDA proposed removing it from US over-the-counter decongestants, citing effectiveness, not safety.

In the UK it’s still on sale: the MHRA said there were no new safety concerns and people can keep using these products as directed. Nasal sprays weren’t part of the FDA proposal.

If a blocked nose is the main problem, ask a pharmacist about other options, such as pseudoephedrine (from behind the pharmacy counter) or a short course of a decongestant nasal spray. The NHS says don’t use decongestant sprays or drops for more than 5 days, as they can make a blocked nose worse. Steam and sleeping propped up help too (see how to sleep with a cold).

Check first if you have high blood pressure (see normal blood pressure readings), heart disease, diabetes, glaucoma, thyroid problems or an enlarged prostate, or take other medicines such as some antidepressants or beta blockers.

Beechams sachets or Lemsip capsules: is there a difference?

Mostly the form and the amounts, not the type of medicine. Hot drink sachets, capsules and tablets usually contain the same ingredients: paracetamol plus a decongestant, sometimes with caffeine. A hot drink sachet isn’t gentler. It’s a full medicine dose, so it counts towards your paracetamol total like a tablet does.

Figures are from the official product information on the emc, checked November 2026. Versions of the same brand can differ, so read the box you buy. Day and night packs often add a drowsy antihistamine to the night dose: don’t drive after it or drink alcohol with it.

Can children take cold and flu tablets?

Not adult ones. Many adult cold and flu products, including both examples above, are for ages 16 and over. The MHRA advises that over-the-counter cough and cold medicines shouldn’t be used in children under 6, and that children aged 6 to 12 should only have them on a pharmacist’s advice. For a child’s aches or temperature, children’s paracetamol or ibuprofen at the dose on the pack for their age is usually the first choice.

Never give aspirin to children under 16, and don’t give honey to babies under 12 months, the NHS says. More on colds and flu in children.

Do you actually need cold and flu tablets?

Often not. The NHS advice for colds and flu is rest, plenty of fluids, and paracetamol or ibuprofen for aches and temperature. Plain paracetamol does the same painkilling job as the paracetamol in a combination product, which mainly adds a decongestant. Antibiotics won’t help either illness.

For specific symptoms, see sore throat remedies and why a cough is worse at night. The evidence for vitamin C, zinc, elderberry, echinacea and manuka honey is mixed at best. Our winter wellness guide covers the everyday basics.

When to see a GP or call 111

iMost colds get better in about 1 to 2 weeks without seeing a doctor. The NHS says see a GP if:

• you’ve had a high temperature for more than 3 days, or cold symptoms haven’t got better after 10 days
• you’ve had a cough for more than 3 weeks, or feel short of breath or have chest pain
• you have a long-term condition or a weakened immune system, or you’re worried about a child

For flu, get an urgent GP appointment or call 111 if you’re 65 or over, pregnant, have a long-term condition, feel very unwell or short of breath, or your symptoms haven’t improved after 7 days. Call 999 or go to A&E for sudden chest pain, severe difficulty breathing or coughing up blood.